Mass media is recognized in health communication as a gatekeeper, alerting the public to what is important with a focus on accuracy and relevancy. This is done through media framing, by which mass media sets the tone through which the public will view the message. Social media has emerged as a force in health communication with the same potential for media framing as mass media; however, with social media there is no formal gatekeeper. Looking at two major disease outbreaks, Ebola and Zika, this chapter examines the influence and effect of social media on health communication. The Zika outbreak in Miami was examined with social listening methods to determine both the effect of mass media on social media and of social media on the effectiveness of traditional health communication outlets to spread their message. The authors conclude that social media is both an asset and a liability during disease outbreaks, and its effect depends on audiences' cultural attitudes and trust toward authorities and the media.
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There will always be new and recurring disease outbreaks. Although most are relatively predictable in their transmission and evolution, information about outbreaks or epidemics seems to take on a life of its own, with its unfolding drama narrated to the public by the media, and publicly interpreted by audiences through social media. This chapter examines the role of media, and particularly social media, in shaping the public’s understanding and interpretation of infectious diseases and how this relationship between media and public perception may be influenced by cultural attitudes toward risk and trust in sources of information. The interaction of media with infectious disease perceptions occurs on two levels. First, how the media frames a health issue influences the public’s attitude, which in turn influences the public’s behavior on social media and ultimately public opinion. Second, health authorities count on the media to disseminate information about health policies, which influences what people think and how they behave. However, these messages are often adapted or distorted as they make their way through social media.
The media serve as the main source of information in crisis situations, alerting the public to risks to the community and explaining implementation of health policies. In communicating this information, health authorities and policymakers use a variety of media channels -both traditional and social media - to help the public interpret a situation involving infectious disease through media framing, including the choice of language, quoted sources, emphasized perspectives (e.g. behavioral prevention versus medical treatment), groups associated with the disease, and general tone (e.g. alarmist, optimistic, etc.).
To discuss the relationship between public reaction and media coverage on infectious disease, it is first necessary to provide a working definition of mass media, social media, and further describe the two main theoretical constructs at work: the agenda setting function of the media and media framing of health issues. Mass media refers to all outlets relaying information to a large population simultaneously. In our times, this includes print media, such as newspapers and magazines; broadcast media, including television and radio; films; and an ever-growing range of new media outlets applications available on the Internet and through mobile devices. Generally speaking, social media refers to websites and applications that enable users to create and share content. Ellison (2007) defined social network sites as web-based services that allow individuals to construct a public or semi-public profile within a bounded system, and articulate a list of other users with whom they share a connection.
Regardless of the channel, the purpose of media is to disseminate information, particularly news, entertainment and advertising, to a mass audience. While the leading media conglomerates are commercial enterprises, in a democracy, media outlets are also expected to uphold minimal standards of social responsibility such as telling the truth and respecting the audience. Because social media consists largely of audience-generated content, the standards of social responsibility range widely. The relationship between media and the government varies by country and political climate. In democracies with open media systems, traditional media are expected to serve as a watchdog of the government on behalf of the citizens; in some systems, media is used as a propaganda tool by the government to control information; in the libertarian model, the media is controlled by private elites with may or may not support the government. These multiple roles create challenges not only for the media industry, but also for the public, which has to interpret the information presented through the media and use it to make personal choices and participate in the economic and political process. As will be discussed later in this chapter, how the public interpret media messages depends on the cultural attitudes toward authorities, including vertical trust in media. Social media entered into the equation in the early 2000s, and was widely regarded as a democratization of mass media, giving audiences the